BHYT Cost Sharing (VN) API

How much Vietnamese health insurance pays for a visit or stay: card level, right route or self-referral by facility level, 5-year and small-bill rules.

GETPOSThttps://apibox.io.vn/v1/vn-bhyt-cost

Data & JSON▶ Try it online

Give the covered cost and the card code (the benefit level is read from it, as in bhyt-check) or level 1–5, plus the visit (outpatient / inpatient), the facility level under the 2023 medical examination law (primary cấp ban đầu, basic cấp cơ bản, specialized cấp chuyên sâu, with former_level district / provincial / central) and the route (right, self for self-referral, emergency). The API applies Luật BHYT Điều 22 as amended by Luật 51/2024/QH15 and NĐ 188/2025/NĐ-CP: card rate 100 / 95 / 80 %; self-referral 100 % at primary and former district facilities, inpatient 100 % at former provincial facilities, outpatient 50 % there from 1/7/2026 (0 % before), 40 % inpatient at other specialised hospitals, 100 % for diseases on the Ministry of Health lists (listed_disease) and for remote-area cases (remote_area); emergencies count as right route.

It also applies 100 % when one visit costs less than 15 % of the base salary (379,500 VND from 1/7/2026), at primary facilities, and after 5 consecutive years once co-payments in the year exceed 6 months of base salary (15,180,000 VND; pass five_years and copay_paid, and copay_h1 for the 2026 mid-year change). The response lists fund_pays, patient_pays and every rule applied. Drug and service caps and out-of-list items are not modelled.

Parameters

Name	In	Type	Required	Default
`cost`	query	number	yes		Covered cost (VND).
`card`	query	string	no		15-character card code (benefit level read from it).
`level`	query	number	no	`4`	Benefit level 1–5 when no card is given.
`visit`	query	string	no	`outpatient`	outpatient or inpatient.
`facility`	query	string	no	`basic`	primary, basic or specialized.
`former_level`	query	string	no		district, provincial, central, low_score or mid_score.
`route`	query	string	no	`right`	right, self or emergency.
`listed_disease`	query	boolean	no		Disease on the TT 01/2025/TT-BYT lists.
`remote_area`	query	boolean	no		Ethnic minority / poor household in an extremely difficult area, or island resident.
`five_years`	query	boolean	no		5 consecutive years of cover.
`copay_paid`	query	number	no		Co-payments already paid this year.
`out_of_scope_cost`	query	number	no		Costs outside the BHYT scope.
`date`	query	string	no		Date of care (default today).

Example

curl "https://apibox.io.vn/v1/vn-bhyt-cost?card=DN4797931234567&cost=1000000&facility=basic&former_level=provincial&route=self&date=2026-11-11" \
  -H "Authorization: Bearer YOUR_API_KEY"

const res = await fetch('https://apibox.io.vn/v1/vn-bhyt-cost?card=DN4797931234567&cost=1000000&facility=basic&former_level=provincial&route=self&date=2026-11-11', {
  method: 'GET',
  headers: {
    Authorization: 'Bearer YOUR_API_KEY',
  },
});
const data = await res.json();
console.log(data);

import requests

res = requests.get(
    "https://apibox.io.vn/v1/vn-bhyt-cost?card=DN4797931234567&cost=1000000&facility=basic&former_level=provincial&route=self&date=2026-11-11",
    headers={"Authorization": "Bearer YOUR_API_KEY"},
    timeout=30,
)
print(res.json())

<?php
$ch = curl_init('https://apibox.io.vn/v1/vn-bhyt-cost?card=DN4797931234567&cost=1000000&facility=basic&former_level=provincial&route=self&date=2026-11-11');
curl_setopt_array($ch, [
    CURLOPT_RETURNTRANSFER => true,
    CURLOPT_HTTPHEADER => ['Authorization: Bearer YOUR_API_KEY'],
]);
$response = curl_exec($ch);
print_r(json_decode($response, true));

Response

{
  "date": "2026-11-11",
  "cost": 1000000,
  "out_of_scope_cost": 0,
  "card": {
    "normalized": "DN4797931234567",
    "group": "DN",
    "group_vi": "Người lao động làm việc theo hợp đồng lao động, người quản lý trong doanh nghiệp nhà nước",
    "benefit_level": 4,
    "valid": true,
    "errors": [],
    "warnings": []
  },
  "benefit_level": 4,
  "visit": "outpatient",
  "facility": "basic",
  "former_level": "provincial",
  "route": "self_referral",
  "fund_pays": 400000,
  "patient_pays": 600000,
  "fund_share": 0.4,
  "rate_applied": 0.4,
  "route_factor": 0.5,
  "card_rate": 0.8,
  "thresholds": {
    "base_salary": 2530000,
    "base_salary_ref": "Nghị định 161/2026/NĐ-CP",
    "small_visit": 379500,
    "five_year_cap": 15180000
  },
  "rules_applied": [
    "Card benefit level 4: 80% of covered costs (Luật BHYT Điều 22 k.1)",
    "Self-referral, outpatient at these facilities from 01/07/2026: 50% of the card rate (NĐ 188/2025 Điều 19)"
  ],
  "legal": [
    {
      "ref": "Luật BHYT 2008 sửa đổi bởi Luật 51/2024/QH15, Điều 22 (VBHN 40/VBHN-VPQH 16/03/2026)",
      "effective_from": "2025-07-01"
    },
    {
      "ref": "NĐ 188/2025/NĐ-CP Điều 17–19",
      "effective_from": "2025-08-15"
    }
  ],
  "note": "Covered costs only (drugs and services on the BHYT lists, at the BHYT price). Payment caps on some drugs, supplies and services are not applied.",
  "reviewed": "2026-11-11",
  "disclaimer": "Reference calculation, not legal advice; check the official text."
}

Use cases

Show patients the expected co-payment in a hospital app
Estimate the top-up paid by private health insurance
Explain self-referral rules at a specialised hospital
Track the 5-year co-payment ceiling for a chronic patient

FAQ

What does “former_level” mean?

Since 2025 facilities are graded primary / basic / specialised; the self-referral rate still depends on the facility’s old district, provincial or central level (or its score).

Does it read the card from the government portal?

No: the benefit level is decoded from the card code structure. Validity dates and the registered clinic are not checked.

Are drug caps included?

No: pass only the cost within the BHYT scope at the BHYT price; out_of_scope_cost is paid by the patient except with level 5 cards.

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BHYT Cost Sharing (VN) API

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